SUMMARY/ABSTRACT: This proposal responds to PAR-06-358 "Planning Grants for Translational Research for the Prevention and Control of Diabetes and Obesity." It is estimated that 30 million U.S. adults will have type 2 diabetes by 2050. Contributing to this national trend is the obesity epidemic. Three randomized trials have demonstrated that intensive behavioral interventions can prevent or delay the onset of diabetes. The purpose of this pilot study is to inform a future randomized, controlled, Phase III trial of a population-based, telephonic, exercise and weight loss intervention to translating the findings of the Diabetes Prevention Program into practice. The 1:1 telephonic intervention will be compared to usual care (30 participants in each group, 15 male and 15 female). The intervention will be delivered in weekly, 20 minute calls, for 10 weeks, with maintenance calls biweekly times 3, and monthly times 2, for a total of 15 calls over 24 weeks. Study outcomes will be measured at baseline, 10 weeks, and 24 weeks. Our specific aims are to: 1) Evaluate the feasibility and acceptability of a telephone-based weight loss and exercise intervention, including recruitment, intervention acceptance, and continued participation;2) Conduct a preliminary evaluation of the intervention's effectiveness including, weight loss at 10 and 24 weeks in the intervention vs. usual-care groups and physical activity in the intervention vs. usual-care groups;and 3) Inform the design and implementation of a full-scale effectiveness trial, including refining the intervention, refining measurement strategies, obtaining data to refine sample size estimates, and using intervention time-logs to estimate program costs. NARRATIVE: The Diabetes Prevention Project and other intervention trials showed that intensive weight loss and exercise interventions can reduce diabetes risk. The public health challenge is to translate the results of these efficacy trials into effective, population-based programs that can cost- effectively reach large numbers of people at risk, achieve similar weight loss and exercise goals, and sustain these changes over time. Our goal is to translate the DPP into a telephone-based intervention that meets this challenge.